Treatment patterns and costs associated with sessile colorectal polyps.

Journal Article

OBJECTIVES: Because of the paucity of existing literature on treatment and costs associated with sessile lesions, the objectives of this study were to perform a retrospective analysis on patients with sessile polyps to identify patient and polyp characteristics, to determine treatment patterns, and to estimate the cost of treating these patients. METHODS: We conducted a retrospective, observational cohort study of 280 patients who presented to a large teaching hospital between 1997 and 2000 with at least one sessile or broad-based pedunculated colorectal polyp of any size or histology, not including adenocarcinoma greater than stage T1. RESULTS: Mean polyp size was 1.3 cm, and two thirds of polyps were removed in a single procedure. The number of repeat procedures increased with polyp size (Kendall T-b = 0.47; 95% CI = 0.39-0.55). Patients with polyps > or = 2 cm were 5.88 times more likely than patients with smaller polyps to undergo a surgical procedure. Surgical procedures required 88.01 min longer than nonsurgical procedures (95% CI = 74.43-102.42). Mean total cost of treatment was $2,038 (range $153 to $14,838). Open resection ($6,165) was the most costly surgical procedure, and piecemeal polypectomy ($892) was the most costly nonsurgical therapeutic procedure. CONCLUSIONS: One third of polyps required more than one procedure. Surgical procedures accounted for the majority of resource use in this sample. Finally, patients with polyps > or = 2 cm incurred almost half the total costs while accounting for only 22% of the sample. The greatest economic gains could be made by improving efficiency of polyp removal for these patients.

Full Text

Duke Authors

Cited Authors

  • Onken, JE; Friedman, JY; Subramanian, S; Weinfurt, KP; Reed, SD; Malenbaum, JH; Schmidt, T; Schulman, KA

Published Date

  • November 2002

Published In

Volume / Issue

  • 97 / 11

Start / End Page

  • 2896 - 2901

PubMed ID

  • 12425565

International Standard Serial Number (ISSN)

  • 0002-9270

Digital Object Identifier (DOI)

  • 10.1111/j.1572-0241.2002.07058.x

Language

  • eng

Conference Location

  • United States